There are myriad treatments out there, and dermatologist Jerry Shapiro says while there are some tried and true remedies, they are not effective for everyone

There are some tried and true baldness remedies, but they don't work for everyone, according to dermatologist Jerry Shapiro.

Photograph by: Julian Herbert
, Getty Images

Hair transplant specialist Dr. Jerry Shapiro, a Vancouver dermatologist who is a clinical professor at the University of B.C. with practices in The Skin Centre near Vancouver General Hospital and his New York office, walked The Sun through some of the hair-loss treatments on the market.

(Full disclosure: Shapiro is a co-founder and shareholder of RepliCel Life Sciences Inc. He is also on the company's scientific advisory board.)

Question: What’s new in hair transplants?

Answer: Follicular unit extractions, where you take a few hairs at a time from the back (of the scalp) rather than strip harvesting, which is traditional. You can do it by follicular unit extraction with a special machine called a NeoGraft machine. There are even robots that can do follicular unit extraction as well. I think more and more people are going to be getting into it, but I don’t think anyone is doing it in B.C. yet.

Q: What happens in a typical hair transplant?

A. I take a strip from the back of the scalp that’s 20 cm long by 1.3 cm. We then cut it into tiny little slivers and we plant the slivers into little holes on the scalp. They’re not called plugs anymore because the old hair plugs had 20 or 30 hairs per graft. Now they are only singles, doubles or triples. (One, two or three hairs per graft.)

Q: How much does it cost?

A: It depends on the number of grafts. At our clinic we vary from $6,550 to $8,900.

Q: Who can do it?

A: Any licensed physician can do hair transplants, a family physician can do it, a psychiatrist can do it, a pathologist can do it. As long as you have an MD, you can do it. Dermatologists are specialists in hair as well as skin and nails. We truly understand hair and skin diseases.

Q: What are the biggest trends you’re seeing now?

A: We do it on more and more women. When I started this in 1992, we hardly did any women. Now one in three are women.

Q: Why?

A. Because they can afford it. Women are more in the workplace. They have the money, the freedom. Plus the technique is better. It’s more advanced. It works as long as they still have a nice thick donor area at the back of the scalp and not all women have a good donor area like men do. If you’re thinning in the back, it’s not going to work that well.

Q: When is it hopeless?

A: If they’re very bald and they just have a fringe, it might not be worth doing. But some people still want a little hair in the front — even just a sprinkling.

Q: How well does minoxidil — also sold as Rogaine — really work?

A: It depends what your expectations are. If your expectation is to keep what you have, then it works very well. If your expectation is to grow a lot of hair, it doesn’t grow a lot of hair, but it grows mild to moderate hair in some individuals. It’s more for prevention, but it probably does regrow hair in around one-third of patients.

Q. What’s PRP cell therapy or so-called “vampire therapy?”

A. Who calls it vampire? Is that your idea? (laughs)

PRP is platelet-rich plasma. It’s where the doctor takes a person’s blood and spins it down to its components and just takes the portion that’s filled with platelets and is probably loaded with growth factors. You then take that and inject it into the scalp. And we think that it may work to grow hair, but there aren’t enough studies to prove that it really works. There are doctors who use it and they’re convinced it works — and I’m not saying they’re doing anything wrong — but I need to see more double-blind, placebo-controlled studies. I’m trying to negotiate a study on this in my New York office. I don’t feel comfortable using it until I see more data, but it looks intriguing.

Q: Is it expensive?

A: I don’t know any dermatologist doing it in Vancouver, but it’s very popular in New York, in Europe, in South America, in Asia and in India.

It depends what your budget is. For some people it’s not a lot, for others it is. I know that in New York one set of injections can cost more than $1,000 and they have to come back several times.

Q: Latisse? Is it just for eyelashes?

A: Allergan, the manufacturers of Latisse, completed a double-blind and placebo-controlled study in New York on the use of this particular molecule on the scalp. We know it works fabulously for eyelashes, no question, but does it works on the scalp? They have not released the results of the study, so I don’t know. However, I have used it in some patients who have had some regrowth, but I can’t give you a percentage. That study will have that data if it ever gets published.

Q. What about LaserCap or HairMax LaserCombs?

A. They are lasers that are approved by the U.S. Food and Drug Administration to grow hair. I think there may be something behind it, but I haven’t seen enough data to convince me that it’s something I’m going to use on a regular basis with my patients.

Q: What’s Viviscal?

A: Viviscal has been around since I was a resident and that was more than 20 years ago. I would like to see more scientific data to show that it works before I would recommend it to patients. It may be more refined than it was when I was a resident, but its main ingredient is shark cartilage.

Q: Can shampoo help?

A: A shampoo can offer a coat that makes the hair look thicker. A conditioner can coat the hair shaft making it more shiny so that it looks better, but it doesn’t grow more hair. There’s a shampoo with ketoconazole called Nizoral shampoo. I’d recommend it only if people have dandruff, that’s what it’s mainly used for. It does have some anti-androgen effects — that means anti-male hormone which is good — but whether it grows hair is another story.

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